Sleep in the Intensive Care Unit

Abstract

Sleep is an important physiologic process, and lack of sleep is associated with a host of adverse outcomes. Basic and clinical research has documented the important role circadian rhythm plays in biologic function. Critical illness is a time of extreme vulnerability for patients, and the important role sleep may play in recovery for intensive care unit (ICU) patients is just beginning to be explored. This concise clinical review focuses on the current state of research examining sleep in critical illness. We discuss sleep and circadian rhythm abnormalities that occur in ICU patients and the challenges to measuring alterations in circadian rhythm in critical illness and review methods to measure sleep in the ICU, including polysomnography, actigraphy, and questionnaires. We discuss data on the impact of potentially modifiable disruptors to patient sleep, such as noise, light, and patient care activities, and report on potential methods to improve sleep in the setting of critical illness. Finally, we review the latest literature on sleep disturbances that persist or develop after critical illness.

The Psychometric Properties of Richard Campbell Sleep Questionnaire in Patients in Intensive Care Unit

“…Patients admitted to the intensive care unit (ICU), who are usually critically ill patients, need more sleep, however, they are at a higher risk for sleep deprivation, poor sleep quality, and disturbed sleep-wake cycle (3,4).…”

An investigation of light and sound levels on intensive care units in China

“…[3][4][5][6] Reported common circadian rhythm, producing negative impacts on cardiovascular and physiological function. 7,14 The World Health Organization (WHO) guidelines recommend that the average sound levels in hospital should not exceed 30 dB(A) during the day or night, and night-time peak levels should not exceed 40 dB(A). 14 However, studies in specific countries have reported sound levels in ICUs that exceed these recommendations.…”

Using Music to Promote Sleep for Hospitalized Adults

“…Sleep problems exacerbate the healing process during hospitalization and can endure beyond hospitalization. [1][2][3] Researchers in one study 4 documented that sleep difficulties may endure beyond hospitalization: 50% of respondents reported moderate to severe sleep problems 1 week after discharge. Other studies have offered evidence that sleep problems experienced during hospitalization increase the risk for development of chronic insomnia.…”

“…6,7 Other sleep disruption factors include lighting that interferes with sleep-wake cycles, pain, anxiety, and symptoms related to patients' underlying illness. 4 Many of these sleep-disrupting factors are amplified in intensive care units.…”